Long-term Follow Up Results of Nonoperative Treatment for Critical Lower Extremity Ischemia.
- Author:
Jae Young CHOI
1
;
Min Soo SON
;
Kil Yeon LEE
;
Sang Mok LEE
;
Suck Hwan KOH
;
Sung Wha HONG
;
Choong YOON
;
Soo Myeong OH
;
Ho Chul PARK
Author Information
1. Department of Surgery, Kyung Hee University School of Medicine, Seoul, Korea. miumiup@unitel.co.kr
- Publication Type:Original Article
- Keywords:
Revascularization;
Critical;
Extremity;
Ischemia
- MeSH:
Amputation;
Cause of Death;
Extremities;
Female;
Follow-Up Studies*;
Humans;
Hypertension;
Interviews as Topic;
Ischemia*;
Limb Salvage;
Lower Extremity*;
Male;
Medical Records;
Mortality;
Myocardial Ischemia;
Retrospective Studies;
Survivors
- From:Journal of the Korean Society for Vascular Surgery
2003;19(1):32-38
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Immediate revascularization is required for patients with critical lower extremity ischemia, but sometimes only nonoperative treatments are performed due to multilevel arterial occlusive lesions, poor outflow tracts, deteriorated general conditions, and severe associated diseases. We undertook this study to detrmine the long-term results of nonoperative treatments for patients with critical lower extremity ischemia. METHOD: From January 1992 to July 2002, among the patients with lower extremity arterial disease who visited the Department of Surgery at Kyung Hee Medical Center, 72 patients with critical lower extremity ischemia who had been treated with only conservative managements were chosen. Medical records were reviewed retrospectively and telephone interviews were performed. We assessed the functional outcome of the salvaged limb according to the recommended scale for gauging changes in clinical status, the 1997 revised version. RESULT: There were 63 men and 9 women (M : F=7 : 1), and mean age was 70.1 years. At median follow-up of 64.7 months, amputation rate was 27.8%, limb salvage rate was 71.9%, and the mortality rate was 20.8%. Cerebrovascular attacks (40%) and ischemic heart disease (27%) were the major causes of death. Underlying disease were diabetes (65.3%), hypertension (54.2%), ischemic heart disease (11.1%), and previous cerebrovascular attacks (13.9%). Clinical categories of involved patients were grade II (ischemic rest pain) in 80.5%, and grade III (tissue loss) in 19.5%. In survivors with limb salvage, functional outcomes were +3 in 12.5%, +2 in 26.8%, +1 in 35.7%, 0 in 23.2%, and -1 in 1.8%. CONCLUSION: The long-term results of this study suggest that nonoperative treatments for patients with critical lower extremity ischemia can achieve a higher limb salvage rate and significant improvements in the functional outcomes of salvaged limbs.
